Sandy Michelet-Vialva, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013874 Issued in GA

Practice address

1755 Parker Rd SE
Suite A110
Conyers, GA 30094-6650

Phone

(770) 679-5158

Fax

(770) 679-4821

NPI assigned

Aug 6, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1578794673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1755 PARKER RD SE",
            "address_2": "SUITE A110",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946650",
            "telephone_number": "770-679-5158",
            "fax_number": "770-679-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 PARKER RD SE",
            "address_2": "SUITE A110",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946650",
            "telephone_number": "770-679-5158",
            "fax_number": "770-679-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELET-VIALVA",
        "first_name": "SANDY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mesepp Community, Inc
• Simon Samir Meshil, DC
• Metropolitan Orthopaedic and Sports Specialists, PC
• Vongai Mhute, PT
• Miaz Hair Gallery
• Brett Michael Middleton, D.C.
• Ashley Mierez
• Miles Above Mission Awareness
• Millard I. Ross, M.D., LLC
• Aileen Miller

• General Practice Dentistry in Conyers, GA
• Providers in Conyers, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.